Development of an open heart surgery patient care protocol and its effect on post-sternotomy pain

Patients face many problems due to sternotomy-related pain after open heart surgery. By providing holistic care with care protocols, pain and pain-related problems can be eliminated. The aim of our study is to develop an open heart surgery patient care protocol and examine its effect on pain after sternotomy. Secondly, our study aimed to examine the effect of the protocol on pain-related anxiety, quality of care, vital and biochemical parameters. The study was completed in a single-blind randomized controlled manner with 64 patients. Data were collected using the "Descriptive Characteristics Form", "Numerical Pain Assessment Scale", "Post-Sternotomy Follow-up Form", "State Anxiety Scale" and " Scale for Evaluation of the Quality of Care Given to the Patient in Relief of Post-Operative Pain". Patients in the experimental group were given care in accordance with the developed protocol on postoperative days 0, 1 and 2. Routine nursing care of the intensive care unit was applied to the patients in the control group. ANOVA, descriptive and Student's t test were used to analyze the data. In the statistical evaluation, the difference between the average pain assessment scale scores of the experimental group (1.26±0.80) and the control group (4.32±1.50) was significant (p<0.001). It was determined that the number of analgesics uses in the experimental group (1.41±.80) was statistically significantly (p<0.001) lower than the control group (3.22±1.79). There was a difference between the pretest (39.28±9.77) and posttest (28.28±5.25) state anxiety scale mean scores of the experimental group and the pretest (58.03±7.07) and posttest (44.12±14.61) mean scores of the control group (p<0.001). There was no statistically significant result between the two groups (p = 0.386). The average score of the experimental group on the scale for evaluating the quality of care given to the patient in relieving postoperative pain (66.5±4.6) was found to be higher than the control group (44.03±8.63). A significant difference was also detected between the pulse and saturation values of the experimental and control groups (p<0.001). The developed protocol was found to be effective in reducing pain, NSAID and opioid use and anxiety levels, and increasing the level of care quality. It has also been determined that it reduces the pulse rate by increasing oxygen saturation. It may be recommended to use the protocol in different groups of patients undergoing cardiac surgery, to plan longitudinal studies to determine the continuity of its effect, and to conduct studies to evaluate the experiences of the nurses involved in the protocol and the patients to whom the protocol is applied.